Morphological effects of transfusions with hemoglobin solutions.

Abstract:

:The current investigation describes the morphological and pathophysiological effects of stroma-free hemoglobin solution (SFH) on the liver and kidney. One h after a 75% blood volume exchange in animals receiving 7% SFH, hepatic morphology was normal. Animals whose blood was similarly exchanged with 7% albumin demonstrated evidence of cellular hypoxia. These findings suggested that SFH initially transported and offloaded sufficient oxygen to prevent hypoxic alterations. Twelve and 24 h after exchange with albumin, the livers were normal, whereas those of SFH-transfused rats exhibited centrolobular necrosis. Studies of intravascular volume, free circulating hemoglobin distribution, and urinary volumes revealed that the hemoglobin tetramer was degraded rapidly into monomers which traversed the glomerular basement membrane, causing a diuresis. The latter resulted in a 40% loss of intravascular volume, 6 h after SFH administration. When intravascular volume and hemoglobin concentration were maintained by bolus infusions of SFH, hepatic necrosis did not occur. Free hemoglobin was incorporated into the cytoplasm of proximal renal tubular cells and also appeared in the lumens of the distal tubules. However, 24 h after exchange transfusion, almost all of the hemoglobin had left the kidneys and there was no morphological evidence of renal dysfunction. Serum creatinines were normal after SFH administration. The slight rise in BUN was attributed to the dehydration caused by hemoglobin diuresis.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Friedman HI,DeVenuto F

doi

10.1097/00003246-198204000-00011

subject

Has Abstract

pub_date

1982-04-01 00:00:00

pages

288-93

issue

4

eissn

0090-3493

issn

1530-0293

journal_volume

10

pub_type

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